Healthcare Provider Details

I. General information

NPI: 1508908658
Provider Name (Legal Business Name): PASTORAL CARE AND COUNSELING INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 DURHAM CHAPEL HILL BLVD SUITE 220 CEDAR TERRACE OFFICES
DURHAM NC
27707-6235
US

IV. Provider business mailing address

3325 DURHAM CHAPEL HILL BLVD SUITE 220 CEDAR TERRACE OFFICES
DURHAM NC
27707-6235
US

V. Phone/Fax

Practice location:
  • Phone: 919-489-6452
  • Fax:
Mailing address:
  • Phone: 919-489-6452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. PHYLLIS K. HICKS
Title or Position: DIRECTOR
Credential: D. MIN.
Phone: 919-489-6452